To demonstrate the efficacy of pramipexole combined with L-dopa on patients with idiopathic restless legs syndrome (RLS). Methods: Thirty patients with moderate to severe RLS were randomly divided into the control group and combined group with 15 patients in each. During the 6 weeks of treatment, both groups were given Pramipexole (0.25~0.75 mg/d), and the combined group was additionally given Madopar (62.5~125 mg/d). The international RLS scale (IRLS)，patient global impression (PGI) scale, clinical global impressions-improvement (CGI-I) scale, and Epworth sleepiness scale (ESS) were used to evaluate RLS symptom severity and sleepiness before and after treatment; incidence of adverse events was also recorded throughout the trial. Results: IRLS scores decreased after therapy both in both groups (P＜0.05), and the post-treatment IRLS score in the combined group was lower than that in the control group (P＜0.05). After therapy, CGI-I and PGI scores of the combined group were significantly greater than that in the control group (P＜0.05). ESS scores decreased after therapy in both groups (P＜0.05), and there was no statistical difference between the post-treatment ESS scores of the two groups (P＞0.05). Conclusion: The efficacy of pramipexole combined with L-dopa in the treatment of idiopathic RLS is greater than that of pramipexole alone.